Last week, reports said President Trump was considering an executive order to facilitate selling insurance across state lines. As of this writing, it is unclear when or if that action will take place. However, we asked various insurance executives and policy makers what such an order could mean for their state.

Michael Stollar is the President and COO of HMSA, the Blue Cross Blue Shield plan in Hawaii. He was gracious in providing a response, posted below, on an issue that is still very much a hypothetical. You can read our interview with Stollar from earlier this year here, or watch his keynote address at our 2017 Hawaii State of Reform Health Policy Conference.

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In Hawaii we’ve always taken care of our family, our neighbors, and our communities. It’s a vital part of Hawaii’s culture and one of the reasons our state is a national leader in health.

The Prepaid Health Care Act is part of a tradition of caring and has ensured broad and deep health care coverage in Hawaii and a strong health care system. Bloomberg news recently ranked the state’s health care system as the most efficient in the country.

A law that undercuts Prepaid could erode the health of Hawaii.

Let’s look at someone who is on the verge of developing diabetes. That person needs regular checkups and preventive care from their doctor, and health and well-being programs. This is the kind of health care that’s possible with comprehensive health coverage.

With a health plan that has fewer benefits and higher out-of-pocket costs, that person may not go to the doctor or have access to programs that encourage a healthier lifestyle. That would make a bad situation worse and certainly more expensive in the long run.